From the Guidelines
Symptoms of large adenoids include difficulty breathing through the nose, persistent mouth breathing, snoring, sleep apnea, recurrent ear infections, and a nasal-sounding voice, as supported by recent clinical guidelines 1. These symptoms occur because adenoids are lymphatic tissue located at the back of the nasal cavity that can become enlarged due to infections or allergies. When enlarged, they physically obstruct airflow through the nose and can block the eustachian tubes that connect the middle ear to the throat, leading to fluid buildup and infections in the ears. Some key points to consider:
- Large adenoids can cause chronic nasal congestion, frequent sinus infections, and sleep disturbances such as restless sleep or pauses in breathing during sleep.
- Children may develop a characteristic facial appearance called "adenoid facies," with an open mouth, elongated face, and prominent upper teeth.
- Large adenoids can also cause problems with speech development and may contribute to bad breath.
- Recent studies suggest that adenoidectomy may be beneficial in children over 4 years old with symptoms related to adenoids, but the decision to perform surgery should be made on a case-by-case basis, considering the potential benefits and risks 1.
- The most recent and highest quality study on this topic is from 2022, which provides guidance on the diagnosis and management of adenoids in children 1.
From the Research
Symptoms of Large Adenoids
The symptoms of large adenoids can be categorized into several groups, including:
- Respiratory symptoms:
- Otolaryngologic symptoms:
- Neurocognitive and behavioral symptoms:
- Behavioral and learning difficulties
- Poor attention span
- Hyperactivity
- Below average intelligence quotient 2
- Cardiovascular symptoms:
- Decreased right ventricular ejection fraction
- Left ventricular hypertrophy
- Elevated diastolic blood pressure 2
- Growth and development symptoms:
- Growth failure 2
Treatment-Related Symptoms
Symptoms can also be affected by treatment approaches, such as:
- Reduction in adenoid size and symptom scores with the use of nasal corticosteroids after adenoidectomy 3
- Improvement in chronic obstructive nasal symptoms and adenoid size with long-term maintenance therapy using intranasal corticosteroids 5
- Clinical improvement in adenoid symptoms with combined maximal medical treatment, including intranasal mometasone furoate, oral desloratadine, nasal saline irrigation, and bacteriotherapy 6